Version May 2024
| Aripiprazole extended release | Aripiprazole lauroxil | Flupentixol decanoate* | Fluphenazine decanoate | Haloperidol decanoate | Olanzapine pamoate | Paliperidone palmitate (4-week) | Paliperidone palmitate (12-week) | Paliperidone palmitate (6-month) | Pipotiazine palmitate* | Risperidone microspheres (2-week) | Risperidone subcutaneous | Zuclopenthixol decanoate* | |||
| Trade (brand) name | Abilify Maintena | Abilify Asimtufii | Aristada; Aristada Initio | Fluanxol Depot (Canada) | Generic | Haldol Decanoate | Zyprexa Relprevv | Invega Sustenna | Invega Trinza | Invega Hafyera | Piportil L4 (Canada) | Risperdal Consta; Rykindo¶ | Perseris | Uzedy | Clopixol Depot (Canada) |
| Generation | Second | Second | Second | First | First | First | Second | Second | Second | Second | First | Second | Second | Second | First |
| Injection interval | 4 weeks | 8 weeks | For loading dose (675 mg only) 4 weeks (441, 662, 882 mg) 6 weeks (882 mg only) 8 weeks (1064 mg only) | 2 to 4 weeks | 2 to 4 weeks | 4 weeks | 2 to 4 weeks | 4 weeks | 12 weeks (3 months) | 6 months | 3 to 4 weeks | 2 weeks | 4 weeks | 4 or 8 weeks | 2 to 4 weeks |
| Available dose strengths | 300 mg 400 mg | 720 mg 960 mg | 441 mg 662 mg 675 mg (loading dose) 882 mg 1064 mg | 20 mg/mL 100 mg/mL (variable dose) | 25 mg/mL (variable dose) | 50 mg/mL 100 mg/mL (variable dose) | 210 mg 300 mg 405 mg | 39 mg 78 mg 117 mg 156 mg 234 mg | – 273 mg 410 mg 546 mg 819 mg | 1092 mg 1560 mg | 25 mg/mL 50 mg/mL | 12.5 mg 25 mg 37.5 mg 50 mg | 90 mg 120 mg | 50 mg 75 mg 100 mg 125 mg 150 mg 200 mg 250 mg | 200 mg/mL (variable dose) |
| Dose range (adult)Δ | 300 to 400 mg | 720 to 960 mg | 441 to 1064 mg | 10 to 50 mg | 12.5 to 100 mg | 20 to 450 mg | 150 to 405 mg | 39 to 234 mg | 273 to 819 mg | 1092 to 1560 mg | 75 to 200 mg | 12.5 to 50 mg | 90 to 120 mg | 50 to 250 mg | 100 to 400 mg |
| Maximum recommended dose | 400 mg every 4 weeks | 960 mg every 8 weeks | 882 mg every 4 weeks | 100 mg every 2 weeks | 100 mg every 2 weeks | 450 mg every 4 weeks | 300 mg every 2 weeks | 234 mg every 4 weeks | 819 mg every 12 weeks | 1560 mg every 6 months | 250 mg every 3 weeks | 50 mg every 2 weeks | 120 mg every 4 weeks | 125 mg every 4 weeks or 250 mg every 8 weeks | 600 mg every 2 weeks |
| Conversion from oral tablets | Initiate LAI with 400 mg every 4 weeks. For the first 14 days, overlap with oral aripiprazole (or other oral antipsychotic). or Alternative dosing (Canadian product label): Two separate injections of 400 mg (at different sites) on the same day with a single dose of 20 mg oral aripiprazole given concurrent to injection.[3] | Initiate LAI with 960 mg every 8 weeks. For the first 14 days, overlap with oral aripiprazole (or other oral antipsychotic). If switching from 4-week aripiprazole LAI (Abilify Maintena), administer first dose of 960 mg in place of next scheduled injection; do not overlap with oral treatment. | If stable on oral 10 mg daily, then 441 mg LAI every 4 weeks. If stable on oral 15 mg daily then 662 mg LAI every 4 weeks, or 882 mg LAI every 6 weeks, or 1064 mg LAI every 8 weeks. If stable on oral ≥20 mg daily, then 882 mg LAI every 4 weeks. Oral aripiprazole should be continued for 21 days after the first dose of LAI. or A single dose of 30 mg oral aripiprazole plus a one-time 675 mg loading dose may be given on the same day or up to 10 days prior to expected maintenance injection with no additional oral overlap | Initiate LAI at 4 times daily oral dose every 2 weeks or 8 times daily oral dose every 4 weeks. For first week, overlap with oral treatment. | 1 mg of oral daily approximately 1.25 mg LAI every 3 weeks. | Initiate LAI at 10 to 20 times daily oral dose, up to 100 mg. If initial conversion requires >100 mg, follow by balance in 3 to 7 days. Then administer at 4-week intervals. The need for overlap with oral therapy varies based on initial LAI dose selected and clinical response; refer to UpToDate text. | If stable on oral 10 mg daily, then 210 mg LAI every 2 weeks or 405 mg LAI every 4 weeks for first 8 weeks, then 150 mg IM LAI every 2 weeks or 300 mg every 4 weeks. If stable on oral 15 mg daily, then 300 mg LAI every 2 weeks for first 8 weeks, then 210 mg LAI every 2 weeks or 405 mg LAI every 4 weeks. If stable on oral 20 mg daily, then 300 mg LAI every 2 weeks. | Conversion from oral extended release:
| Conversion from oral tablets is not available. Conversions from various doses of paliperidone palmitate 4-week LAI, once it has been established as adequate treatment, are shown in the footnote.◊ | Conversion from oral tablets is not available. Conversions from various doses of paliperidone palmitate 4-week LAI or paliperidone palmitate 12-week LAI, once established as adequate treatment, are shown in the footnote.§ | Discontinue oral treatment. Initiate at 50 to 100 mg LAI every 3 weeks. Individualize dose and interval in 25 mg increments based on response no more frequently than every 2 to 3 weeks. | If stable on ≤3 mg daily, then 25 mg every 2 weeks. If stable on >3 to ≤5 mg daily, then 37.5 mg every 2 weeks. If stable on >5 mg daily, then 50 mg every 2 weeks.[4] For the first 3 weeks (Risperdal Consta) or first week (Rykindo), overlap with full-dose oral treatment. | If stable on 3 mg daily, then 90 mg LAI monthly. If stable on 4 mg daily, then 120 mg LAI monthly. | If stable on 2 mg daily, then 50 mg LAI monthly or 100 mg LAI every 2 months. If stable on 3 mg daily, then 75 mg LAI monthly or 150 mg LAI every 2 months. If stable on 4 mg daily, then 100 mg LAI monthly or 200 mg LAI every 2 months. If stable on 5 mg daily, then 125 mg LAI monthly or 250 mg LAI every 2 months. | If stable on oral dose up to 20 mg daily, then 100 mg LAI every 2 weeks. If stable on 25 to 40 mg oral daily, then 200 mg LAI every 2 weeks. If stable on 50 to 75 mg oral daily, then 300 mg LAI every 2 weeks. If stable on more than 75 mg daily, then 400 mg LAI every 2 weeks. |
| Injection site | Deltoid or gluteal | Gluteal | Deltoid (441 and 675 mg only) Gluteal (441, 662, 675, 882, or 1064 mg) | Gluteal or lateral thigh¥ | Gluteal‡ | Gluteal‡ | Gluteal only | Deltoid only (load) Deltoid or gluteal (maintenance) | Deltoid or gluteal | Gluteal | Gluteal | Deltoid or gluteal (Risperdal Consta) Gluteal (Rykindo) | Abdomen or back of the upper arm | Abdomen or back of the upper arm | Gluteal or lateral thigh¥ |
| Injection technique | Standard | Standard | Standard | Z-Track | Z-Track | Z-Track | Standard | Standard | Standard | Standard | Z-Track | Standard | Subcutaneous | Subcutaneous | Z-Track |
| Solubilization and vehicle | Low solubility particles in aqueous suspension | Low solubility particles in aqueous suspension | Low solubility particles in aqueous suspension | Ester in medium chain triglycerides or coconut oil | Ester in sesame seed oil | Ester in sesame seed oil | Nanoparticles in aqueous suspension | Nanoparticles in aqueous suspension | Nanoparticles in aqueous suspension | Low solubility particles in aqueous suspension | Ester in sesame seed oil | Microsphere matrix in aqueous suspension | Suspended in polymer solution | Suspended in copolymer solution | Ester in low viscosity vegetable oil |
LAI: intramuscular long-acting injectable (also known as "depot" injection).
* Not available in the United States. Product details shown from Health Canada Product Monograph.
¶ Approved in the United States and elsewhere. In the United States, Rykindo is not considered a generic equivalent to Risperdal Consta. If switching from Risperdal Consta to Rykindo, initiate at same dose starting 4 weeks after the last injection; do not overlap with oral treatment.
Δ Significant dosing reduction required for older or debilitated adults and patients with low cardiac output or hepatic or renal insufficiency. Certain products are not recommended in renal insufficiency. For additional information, refer to Lexicomp individual drug monographs included with UpToDate.
◊ Paliperidone palmitate 12-week LAI suspension is to be used only after adequate treatment and dose have been established with paliperidone palmitate 4-week LAI suspension for at least 4 months; the last two 4-week injection cycles should be the same dose before starting the 12-week preparation.
Recommended conversions:
Conversion from paliperidone palmitate 4-week LAI 39 mg to the 12-week preparation was not studied.
§ Paliperidone palmitate 6-month LAI suspension is to be used only after adequate treatment and dose have been established with paliperidone palmitate 4-week LAI for a minimum of 4 months (the last two 4-week injection cycles should be the same dose before starting the 6-month preparation) or paliperidone palmitate 12-week LAI for 1 cycle (3 months).
Recommended conversions:
Conversion from paliperidone palmitate 4-week LAI 39, 78, or 117 mg doses to the 6-month preparation were not studied:
Conversion from paliperidone palmitate 12-week LAI 273 or 410 mg doses to the 6-month preparation were not studied.
¥ Lateral thigh administration is not listed in the Health Canada monograph but is approved in other countries.
‡ Alternatively, fluphenazine and haloperidol LAI may be given in the deltoid based upon clinical experience. For deltoid administration, use of a 23 gauge, 1 inch needle is appropriate for most adults; volume per injection is typically limited to 1 mL at this site. Deltoid administration is off-label and published clinical data are unavailable.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
